| NPI | 1609329069 |
|---|---|
| Former Name | BRIANA LYNN HENDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2016-0056) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NM PA2016-0056) |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2022-12-12 |